Laparoscopic transperitoneal hernia repair (TAPP) in emergency: long-term follow-up in a high volume centre

Zanoni, Adelinda; Delcarro, A.; Ciccarese, Francesca; Villa, Roberta; Oldani, Alberto; Giorgi, Riccardo; Rubicondo, Carolina; Bonaldi, Marta; Cesana, Giovanni; Uccelli, Matteo; Carli, Stefano De; Ismail, Ammar; Ferrari, Denise; Olmi, Stefano

doi:10.1007/s10029-021-02516-3

Cited by 10 publications

(11 citation statements)

References 30 publications

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“…There were no intraoperative complications typically related to laparoscopy, such as bowel or vascular injuries often associated with the introduction of trocars. Our conversion rate was zero, proving to be lower than that currently reported in the literature [ 9 , 21 ].…”

Section: Discussioncontrasting

confidence: 74%

Management of groin hernias in emergency setting: differences in indications and outcomes between laparoscopic and open approach. A single-center retrospective experience

Sbacco,

Petrucciani,

Lauteri

et al. 2024

Langenbecks Arch Surg

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Purpose The use of minimally invasive groin hernia repair techniques in an emergency setting is still debated and its widespread is limited. The aim of this study is to evaluate the safety and efficacy of the laparoscopic transabdominal preperitoneal (TAPP) technique in the treatment of inguinal and femoral hernias in emergency setting based on our experience, comparing indications and outcomes with the open technique. Methods A retrospective analysis was performed including all patients with incarcerated and/or strangulated groin hernia who underwent emergency surgery from November 2019 to September 2022. Perioperative variables and short- and long-term outcomes were examined. Statistical analysis was performed using chi-square test for nominal variables and Student’s t test for continuous ones. A p value < 0.05 was considered statistically significant. Results Sixty-six patients were included: 29 patients were treated with TAPP technique (Tapp group) and 37 with open technique plus diagnostic laparoscopy (Open group). Patients in the TAPP group were younger, had less severe clinical scenarios, and had a trend for lower Charlson Comorbidity Index, whereas ASA score and BMI were similar. The small bowel was more frequently herniated in the open group. Bilateral hernia repair was performed in 20.69% of patients in the Tapp group versus 0% in the Open group (p = 0.004). Bowel resection was more frequent in the open group (48.65% vs 0% of the Tapp group, p < 0.001) length of surgery was comparable in the two groups. In the Tapp group, the length of hospitalization was significantly shorter (2.59 ± 2.28 days vs. 9.08 ± 14.48 days; p = 0.023). Postoperative complications, according to Clavien-Dindo, were more severe in Open group where there were two deaths. There were no differences in the number of readmission and re-operations at 30 days and in the recurrence rate. Conclusions Emergency repair of inguinal and femoral hernias using TAPP is a valuable option, safe and feasible in selected patients. In this series, indications for TAPP were reserved to younger patients with less comorbidities and less severe clinical scenario. Future randomized studies are needed to compare TAPP with open emergency hernia surgery in all settings. Potential advantages of TAPP are the reduction of postoperative complications, earlier recovery, and the possibility of bilateral treatment.

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Section: Discussioncontrasting

confidence: 74%

Management of groin hernias in emergency setting: differences in indications and outcomes between laparoscopic and open approach. A single-center retrospective experience

Sbacco,

Petrucciani,

Lauteri

et al. 2024

Langenbecks Arch Surg

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“…Zanoni et al . in their recent series of 47 patients with emergency presentation who underwent laparoscopic (TAPP) repair proved the safety of laparoscopic surgery 13 . Kepičová et al .…”

Section: Discussionmentioning

confidence: 98%

“…Zanoni et al in their recent series of 47 patients with emergency presentation who underwent laparoscopic (TAPP) repair proved the safety of laparoscopic surgery. 13 Kepičov a et al study shown it is safe to perform laparoscopic (TAPP) approach for incarcerated inguinal hernia. 14 However, in our study only 2two patients underwent laparoscopy and only one had TAPP with no reported complications.…”

Section: Discussionmentioning

confidence: 99%

Emergency groin hernia: outcome after mesh and non‐mesh repair

Kumar

Tan

et al. 2022

ANZ Journal of Surgery

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Background Emergency inguinal and femoral hernia repair can be done by suture or mesh repair, there is still scepticism around using mesh. We aim to evaluate the usage of mesh and the outcome of emergency groin hernia repair after mesh and suture repair. Methods Retrospective cohort study of adult patients who underwent emergency inguinal and femoral hernia repair from 1st January 2018 to 31st July 2020. Electronic data and case notes were reviewed and outcome data were collected. Results Eighty‐nine emergency groin hernia repairs were carried out. Sixty‐two were males, 60 inguinal hernia and 29 femoral hernia. Median age was 72 years (range 20–95). 74 (83.1%) were primary hernia and 15 (16.9%) recurrent hernias. 67 (75.3%) mesh and 22 (24.7%) suture repairs were carried out. Eleven cases required bowel resection and of those 10 had suture repair. Inguinal hernia was more likely to have mesh repair as compared to femoral (P‐value 0.002). Median length of stay was significantly lower in mesh group 2 days (1–5 IQR) versus 7.5 days (5–11 IQR) in suture repair group (P‐value <0.0001). Five cases (6.74%) had wound complications (3 wound infections, 2 haematoma). With median 20 months (range 6–36 months) follow‐up, 1 recurrence each in both mesh and suture repair groups, no mesh infection and 2 (2.2%) 30‐day mortality recorded. Wound infection, recurrence and reoperation were not statistically different in two groups. Conclusion Emergency groin hernia are amenable to mesh repair and in case of bowel resection or gross contamination non‐ mesh repair is recommended.

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“…TAPP repair has been shown to be associated with a reduced incidence of postoperative complications and discomfort compared with open mesh repair. [13][14][15][16] The standard approaches for TAPP hernia repair are characterized by their high level of complexity and steep learning curve. 17 Furthermore, hernia recurrence is not infrequent when the procedure is conducted by surgeons lacking the necessary skills and expertise.…”

Section: Discussionmentioning

confidence: 99%

Comparison of modified tumescent and conventional laparoscopic transabdominal preperitoneal inguinal hernia repair: a retrospective clinical study

Hu,

Zhang,

Wang

et al. 2024

J Int Med Res

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Objective Laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair poses certain challenges to less experienced surgeons. This study was performed to compare the clinical outcomes of modified tumescent laparoscopic TAPP (MT-TAPP) inguinal hernia repair versus conventional laparoscopic TAPP (CL-TAPP) inguinal hernia repair. Methods We retrospectively analyzed the perioperative data of patients with inguinal hernias who underwent either MT-TAPP repair (n = 57) or CL-TAPP repair (n = 54) at the General Surgery Department of Nanjing Yimin Hospital from November 2019 to June 2023. Results The durations of the total operation and the preperitoneal space dissection were shorter in the MT-TAPP than CL-TAPP group. The estimated blood loss volume was lower in the MT-TAPP than CL-TAPP group. The visual analogue scale scores recorded at the 12- and 24-hour postoperative time points showed significantly greater reductions in the MT-TAPP than CL-TAPP group. Conclusions Using liquid injection and gauze dissection is both safe and practical. This technique results in a shortened total operation time, less time spent on preperitoneal space dissection, decreased estimated blood loss, and less severe postoperative pain.

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Laparoscopic transperitoneal hernia repair (TAPP) in emergency: long-term follow-up in a high volume centre

Cited by 10 publications

References 30 publications

Management of groin hernias in emergency setting: differences in indications and outcomes between laparoscopic and open approach. A single-center retrospective experience

Management of groin hernias in emergency setting: differences in indications and outcomes between laparoscopic and open approach. A single-center retrospective experience

Emergency groin hernia: outcome after mesh and non‐mesh repair

Comparison of modified tumescent and conventional laparoscopic transabdominal preperitoneal inguinal hernia repair: a retrospective clinical study

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